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However, analyses of the IGF1 serum levels in patients with congestive heart failure (CHF) from different causes showed increased as well as unchanged levels. Furthermore, despite improvements of cardiac function in several small open growth hormone-substitution studies, these effects could not be confirmed in two large randomised double-blind studies. 2 Nevertheless, we observed a marked increase of the left ventricular ejection fraction in patients with a pronounced increase of IGF1 serum levels during recombinant human growth hormone treatment. 3 Thus, we assume that the growth hormone/IGF-system is differently altered in patients with CHF due to different causes and might influence the course of the disease. METHODS We examined 90 patients with idiopathic dilated cardiomyo- pathy between 1992 and 1997 after exclusion of secondary forms and diseases, that influence the growth hormone system. The follow-up period ended on 1 October 2000. The end point was death or cardiac transplantation. Additionally, we selected 90 healthy controls matched for sex, age and body mass index (BMI). Blood samples were taken in the early morning in supine position after 12 h of fasting and rest. The serum levels for IGF1, IGF2, IGFBP2, IGFBP3, growth hormone and growth hormone binding protein were determined by specific radio- immunoassays (Mediagnost, Tuebingen, Germany). IGFBP1 serum levels were measured with an immunoradiometric assay (IRMA, DSL, London, UK).

Insulin-like growth factor-binding proteins 2 and 3 are independent predictors of a poor prognosis in patients with dilated cardiomyopathy